中国医科大学学报

中国医科大学学报
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中国医科大学学报 ›› 2017, Vol. 46 ›› Issue (4): 353-356.doi: 10.12007/j.issn.0258-4646.2017.04.017

• 论著 • 上一篇    下一篇

左心室纵向应变预测原发性二尖瓣反流术后左心室收缩功能减低

王晓冰,杨军,陈昕,马春燕   

  1. 中国医科大学附属第一医院心血管超声科,沈阳 110001
  • 收稿日期:2017-01-14 出版日期:2017-04-30 发布日期:2017-04-19
  • 作者简介:王晓冰(1980 -),女,主治医师,博士 .
  • 基金资助:
    沈阳市科学技术计划(F15?199?1?32)

Longitudinal Strain of Primary Mitral Regurgitation Predicts Postoperative Worsening of Left Ventricular Systolic Function

WANG Xiaobing,YANG Jun,CHEN Xin,MA Chunyan   

  1. Department of Cardiovascular Ultrasound,The First Hospital,China Medical University,Shenyang 110001,China
  • Received:2017-01-14 Online:2017-04-30 Published:2017-04-19

摘要: 目的 应用二维斑点追踪成像(STI)技术分析左心室心肌形变在原发性二尖瓣反流(MR)患者中的变化特点,探寻能够敏感预测术后左心室收缩功能减低的左心室心肌形变指标。方法 回顾 2013 年 5 月至 2015 年 6 月在我院行二尖瓣修补的原发性 MR 患者,根据术后射血分数(EF)减低程度分为 MR1 组(EF 减低≤10%)和 MR2 组(EF 减低>10%)。应用二维 STI 技术测量左心室整体纵向应变、整体径向应变和整体圆周应变指标。结果 MR2 组的整体纵向应变高于 MR1 组(P < 0.05),2 组整体径向应变和整体圆周应变无统计学差异。MR 患者术后 EF 减低分数与左心室舒张末内径、左心室收缩末内径、左心室舒张末容积、左心室质量指数、MR 容积和左心室整体纵向应变呈正相关(P < 0.05)。术后 EF 减低>10%的独立预测因子为左心室整体纵向应变(R2 =0.783,P < 0.001),其预测术后 EF 减低>10%的最佳临界值为 19.125%。结论 STI 技术能够敏感预测原发性 MR 患者二尖瓣成形术后左心室收缩功能减低,从而帮助临床选择手术时机。

关键词: 斑点追踪成像, 二尖瓣反流, 左心室功能

Abstract: Objective To analyze subclinical changes of left ventricular deformation by using two-dimensional(2-D)speckle tracking imaging(STI)in primary mitral regurgitation(MR)and to identify sensitive parameters of left ventricular deformation that reflect reduction of left ventricular function after mitral valve repair. Methods We evaluated patients with primary MR who underwent mitral valve repair between May 2013 and June 2015. According to the reduction in ejection fraction(EF),the MR patients were divided into MR1(EF reduction of ≤10%)and MR2 groups(EF reduction of >10%). The parameters of left ventricular deformation were measured by using 2-D STI. Results Compared with the MR1 group,the MR2 group had increased global longitudinal strain(GLS;P < 0.05). A positive correlation was found between postoperative EF reduction and left ventricular internal dimension at end-diastole,left ventricular internal dimension at end-systole,end-diastolic volume,left ventricular mass index,regurgitant volume,and GLS(P < 0.05). GLS showed a diagnostic value in predicting EF reductions of >10%. Conclusion STI is useful for evaluating the postoperative reduction of left ventricular function in primary MR patients and thus is helpful for optimizing surgical timing.

Key words: speckle tracking imaging, mitral regurgitation, left ventricular function

中图分类号: 

  • R445.1
[1] 范苗, 任卫东, 宋光, 李颖. 三维径向应变评价射血分数保留的心力衰竭患者左心室收缩功能变化[J]. 中国医科大学学报, 2018, 47(7): 581-584.
[2] 蒋媛媛 ,徐洋 ,任卫东. 斑点追踪成像结合实时心肌超声造影对心肌不同灌注状态的评价[J]. 中国医科大学学报, 2016, 45(3): 264-268.
[3] 张立敏, 李莎, 魏红, 刘楠, 王盈. 超声二维应变评价法舒地尔对糖尿病合并动脉硬化大鼠左心室功能影响的机制[J]. 中国医科大学学报, 2015, 44(9): 799-802.
[4] 王晓冰,陈昕,马春燕,杨军. 二维斑点追踪成像评价原发性二尖瓣反流患者左室收缩功能隐匿性减低[J]. 中国医科大学学报, 2014, 43(8): 682-685.
[5] 王鑫,贾大林,马春燕,刘爽,张妍,. 二尖瓣环运动速度评价择期经皮冠状动脉介入治疗对急性心肌梗死患者的近期疗效[J]. 中国医科大学学报, 2013, 42(2): 185-186.
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